Mental Health

Patrick J. Skerrett

Heavy drinkers aren’t necessarily alcoholics, but may be “almost alcoholics”

Nearly one-third of American adults are “excessive” drinkers, but only 10% of them have alcohol use disorder (alcoholism). Those numbers, published yesterday in a national survey, challenge the popular idea that most people who drink too much are alcoholics. The new study, done by researchers with the CDC and the Substance Abuse and Mental Health Service Administration, found that about 70% of all American adults drink alcohol at least now and then, about 30% report excessive drinking, and 3.5% have alcohol use disorder. It is higher among heavy drinkers (10%) and binge drinkers, ranging from 4% among those who report binge drinking once or twice a month to 30% among those who binge drink 10 times or more in a month. The knowledge that only 10% of heavy drinkers are alcoholic may be reassuring, but that doesn’t mean the other 90% aren’t have problems with drinking. Some are what Drs. Robert Doyle and Joseph Nowinski call “almost alcoholics.”

Heidi Godman

Does the nose know your future health?

Smells and tastes are often sources of great pleasure. They can also spark wonderful memories. But like memories, these senses can fade, or even disappear, with age. A new study suggests that loss of smell may be a canary in the coal mine—an early warning that something else is wrong in the body. In the study, published in PLoS ONE, older people who lost their sense of smell were more likely to have died over a five-year period. Previous research has linked loss of smell to the onset of neurodegenerative diseases such as Alzheimer’s disease and Parkinson’s disease. What to do If your sense of smell has faded? Don’t jump to conclusions. Diminished smell function is usually caused by problems in the nose, not in the brain.

Beverly Merz

Benzodiazepine use may raise risk of Alzheimer’s disease

Drugs in the benzodiazepine family have long been used to treat anxiety and sleep problems. They can cause a bit of a brain hangover the next day. Experts have long assumed that people’s heads would clear once they stopped taking the drug. That may not be the case. In a study published last night by the journal BMJ, a team of researchers from France and Canada linked benzodiazepine use to an increased risk of being diagnosed with Alzheimer’s disease. In the study, the greater a person’s cumulative dose of benzodiazepines, the higher his or her risk of Alzheimer’s. Taking a benzodiazepine for less than three months had no effect on Alzheimer’s risk. Taking the drug for three to six months raised the risk of developing Alzheimer’s by 32%, and taking it for more than six months boosted the risk by 84%. People taking a long-acting benzodiazepine were at greater risk than those on a short-acting one.

Harvard Women's Health Watch

Suicide survivors face grief, questions, challenges

Nearly 40,000 people a year die by suicide in the United States alone. Each of these deaths leaves an estimated six or more “suicide survivors” — people who’ve lost someone they care about deeply and are left grieving and struggling to understand. The grief process is always difficult. But a loss through suicide is like no other, and grieving can be especially complex and traumatic. People coping with this kind of loss often need more support than others, but may get less. Why? Survivors may be reluctant to confide that the death was self-inflicted. And when others know the circumstances of the death, they may feel uncertain about how to offer help.

Howard LeWine, M.D.

Teen suicide tries increased after FDA toughened antidepressant warning

A few years ago, the U.S. Food and Drug Administration issued warnings that children and teens who took a common kind of antidepressant might experience suicidal thoughts. The point of the warning was to make sure that parents and doctors paid closer attention to kids taking these medications. But the plan may have backfired. A national team of researchers tracked antidepressant use among 2.5 million young people between 2000 and 2010. After the FDA’s warnings in 2003 and 2004, use of commonly prescribed antidepressants fell by 30% in teenagers while suicide attempts rose by 22%. The researchers concluded that the decrease in antidepressant use, sparked by worries over suicidal thoughts, may have left many depressed young people without appropriate treatment and that may have boosted the increase in suicide attempts.

Stephanie Watson

Caffeine and a healthy diet may boost memory, thinking skills; alcohol’s effect uncertain

A study published in this month’s Journal of Nutrition suggests that drinking caffeinated beverages, having the occasional alcoholic drink, and eating a healthy diet may help preserve memory and thinking skills long into old age. In particular, foods that are part of the Mediterranean diet—fruits, vegetables, nuts, fish, olive oil, and whole grains—show promise for preserving memory and preventing Alzheimer’s and other forms of dementia.

Stephanie Watson

When you can’t let go: What to do about hoarding

Many of us have trouble parting with our possessions—even when we no longer need them. Some people hold onto decades’ worth of receipts, newspapers, and other seemingly useless items. They have hoarding disorder—a mental health condition characterized by a compulsive need to acquire and keep possessions, even when they’re not needed. Exactly when a “pack rat” crosses the line into true hoarding has to do with the intensity with which they’re saving, and the difficulty getting rid of things. Severe hoarders can accumulate so much that they render their living spaces unusable—and dangerous. Hoarding also takes an emotional toll on families and friends. Experts recommend treating hoarders with hoarding cognitive behavioral therapy (CBT) to help the person better understand why he or she is hoarding, and to improve decision-making, organizational, and problem-solving skills.

Howard LeWine, M.D.

Too little sleep, and too much, affect memory

When it comes to memory, sleep is a Goldilocks issue: both too much and too little aren’t good. Aim for “just right,” says a new report from the Harvard-based Nurses’ Health Study. Study participants who slept five hours or fewer per night or nine hours or more did worse on tests of memory and thinking skills that those getting seven to eight hours of sleep a night. The researchers estimated that undersleepers and oversleepers were mentally two years older than the women who got seven to eight hours of shut-eye a night. Although this study couldn’t prove that getting too little or too much sleep causes memory and thinking problems, it’s in line with other work showing the potentially harmful effects of poor sleep. Previous research has linked poor sleep with higher risks of heart disease and stroke, type 2 diabetes, and depression.

Stephanie Watson

Expert panel says “no” to widespread testing for Alzheimer’s, dementia

A new report from the Alzheimer’s Association says that as many as 5 million Americans have Alzheimer’s disease or some other form of dementia. Every 67 seconds someone in the United States develops Alzheimer’s disease or dementia. That’s 470,000 Americans this year alone. Given that these thieves of memory and personality are so common and so feared, should all older Americans be tested for them? In proposed guidelines released yesterday, the U.S. Preventive Services Task Force said “no.” Why not? Even after conducting a thorough review of the evidence, the panel said that there isn’t enough solid evidence to recommend screening, especially since not enough is known about the benefits and the harms. In part, the recommendation is based on the sad fact that so far there aren’t any truly effective approaches to stop the forward progress of dementia.

Stephanie Watson

Death of a spouse or partner can lead to heart attack or stroke

The grief of losing a spouse or partner affects not just emotional and mental health, but physical health as well. The surviving spouse or partner often develops health problems in the weeks and months that follow. A study published this week in JAMA Internal Medicine found that individuals who had lost a spouse or partner were more likely to have a heart attack or stroke within the next 30 days. Grief activates the sympathetic nervous system, which is responsible for revving up the body’s fight-or-flight response. That can lead to stress-induced changes in blood pressure, heart rate, and blood clotting. There is also a tendency after such a profound loss for the surviving spouse or partner to disregard his or her own health. It can take several months to a year to work through grief and grieving. If it lasts much longer, and is interfering with daily life—seeing friends, doing once-pleasurable activities—it’s possible that grief has morphed into something more serious, like depression.